Scabies Information

Scabies is a type of skin infection caused by the sarcoptes scabiei mite, characterized by skin itching. Also termed “sarcoptic mange”, the term scabies is actually derived from the Latin word for “scratch”, scabere. The tiny mites burrow within the skin, causing an allergic reaction which in turn leads to a rash and acute itching. Worldwide, there are an estimated 300 million people infected with scabies at any one time.

History of Scabies

An ancient disease, scabies is thought to be over 2,000 years old. Historians speculate that references to scabies are found in the Bible as well as the writings of Aristotle.
The mite affects humans regardless of age, gender, socioeconomic status, or race.

Personal hygiene is often not considered a factor in scabies, although washing contaminated items with hot soap and water can often kill the mites.

Scabies occurs when female mites burrow into the human skin to lay eggs, creating tunnels underneath the surface. The mites feed on human skin and deposit their eggs waste products, which further exacerbate itching.

The eggs, over the course of three to four days, hatch into larvae, which further infect the skin and live on the human host for three to four weeks inside the skin. The scabies feed on the blood of the host to survive, and further burrowing in the skin. The allergic reaction humans have to the mites’ salive, waste, and eggs cause the deep seated and persistent trademark itching of scabies.

Symptoms

The first and most obvious sign of scabies is localized itching. Mites may or not be visible, but usually will leave small red bumps and tiny zig zag pathways where they have burrowed into the skin. These bumps may look like tiny pustles or blisters or resemble small pimples on the skin. Scabies tends to affect areas of skin folds, such as the inside of elbows, between fingers, behind knees, wrists, and other areas.

In patients where the immune system is weakened, scabies can develop to form crusted scabies, an advanced form of the disease where crusted patches of scabs form as a result of infestation. Thickened patches of skin containing hundreds of mites can form in crusted scabies.

Typically, the face and scalp are not affected by scabies. Scabies may remain localized in one area or gradually spread over the surface of the skin.

Risk Factors

Scabies is transferred via skin to skin contact from one human being to another. There have been cases where humans contract scabies from their pets, such as an infected dog or cat, but such occurrences are rare. Highly contagious, scabies mites can live in infected bedding, furniture, mattresses, clothing, keyboards, towels, and literally almost any surface where an infected human’s skin may have rubbed off. Additionally, scabies can survive without a host for up to three days. Once they have infected a human host, the parasitic mites can live anywhere from three to four weeks.

The most common way of contracting scabies is from prolonged physical contact with an infected person. While patients have been known to get scabies from infected bedding or clothing, this is less common. Prolonged physical contact usually means skin to skin contact with an infected person which lasts longer than the average handshake.

High Risk Areas

Scabies often becomes a problem in areas where people exist in close quarters, such as nursing homes, summer camps, or schools. In these environments, one infected individual can spread the disease to anyone he or she comes in close contact with.

The type of scabies that affects humans is different from the mite that infects dogs and cats. Humans typically cannot be infected by the same type of scabies mite that affect pets.

Diagnosis

Scabies can exhibit clinical symptoms and external signs from four to six weeks following the initial infestation for patients who have not previously contracted the disease. In cases where patients have previously contracted scabies, symptoms can develop in as quickly as two to four days.

Once patients have exhibited symptoms, several methods can be used to diagnose the symptoms as scabies. Ink from a pen or topical tetracycline ointment can both be rubbed onto the surface of the skin, then wiped off with an alcohol pad. A special light is then shown on the skin; if the characteristic Z pattern appears under the light, the person has scabies.

Skin Scraping

Another method of diagnosis is to do a skin scraping and examine the specimen under a microscope for presence of mites or their waste. Detecting the presence of mites can often be very elusive, and doctors may have to do numerous skin scrapings in order to effectively rule out or confirm the disease. The skin scrapings must often penetrate several layers of skin in order to correctly test for the presence of mites.

Doctors have been known to order treatment for scabies even if microscopy and other detection techniques do not completely verify the infection. Due to the difficulty of detecting mites under a microscope and sometimes unconfirmed external presence, patients who exhibit the majority of symptoms for scabies are best served undergoing treatment as a preventative measure even if skin scraping or skin tests do not precisely confirm presence of the mite.

Weak Immune Systems

In patients with compromised immune systems such as HIV, AIDS, or auto immune deficiency, healthcare providers should be alerted immediately to the possibility of scabies. Secondary infections can occur as complications in these patients who contract scabies, as well as increased likelihood of acute infection.

Treatment Options

While some infestations may resolve on their own, left untreated scabies can escalate into a highly unpleasant problem. Increased itching, formation of bloody scabs, and patches of scaly skin may accompany an advanced infestation. In such instances, medical treatment is the most efficient and best option. Scabies can also become resistant to medications over time, though this usually only occurs in repeat infections.

Once an infection is confirmed, the patient’s nails should be cut to prevent scabies from hiding under the fingernails or toenails.

Sulfur Soap

Sulfur soap in concentrations of 6% to 10% is a long standing treatment to combat scabies. Patients should wash thoroughly with sulfur soap at least once daily for four days in order to effectively treat the skin. Bedding, clothing, and any other items should be washed in extremely hot water and soap to prevent recontamination.

Neem Oil

Along with sulfur soap, Neem Oil is another effective homeopathic treatment for scabies. Neem Oil is known to have anti fungal and antibacterial properties, which can help treat or soothe the skin of patients infected with scabies.

Tea Tree Oil and Elimite

Tea Tree Oil has been used but with only moderate to little success. For this reason, prescription medications are often warranted for treatment.

One of the most commonly prescribed topical treatments for scabies is Elimite, a cream that must be applied to all areas of the skin (including under the fingernails and toenails) to effectively penetrate the epidermis. Elimite is topically applied all over the infected individual’s body, taking care to cover all surfaces of the skin. After 10 to 14 hours, the Elimite is washed off of the skin in the shower with hot water and soap. A follow up treatment is usually required one to two weeks after the initial treatment.

Permethrin, Oral Medications, & Antihistamines

Permethrin is another popular topically applied medication for the treatment of scabies. The ointment is applied at night and washed off after eight to fourteen hours.

A newer treatment for scabies is an oral medication Ivermectin, taken twice: once at onset, and then another dose two weeks later to completely eradicate the infection. While Ivermectin has some mild side effects, these disappear after treatment and are typically a minimal trade off compared to the uncomfortable constant itching of scabies. Ivermectin is sold as Stromecol in brand name, and is typically given as two 3mg doses two weeks apart.

Antihistamines may also be prescribed to combat the itchiness that often accompanies scabies outbreaks.

Sterilization of Household Items During and After Treatment

All items the infected person has touched- bedding, clothing, towels, etc – should immediately be washed in very hot water to kill remaining mites. A dryer should also be used on a high heat setting to sterilize washed items. Mattresses, carpets, rugs, toys, and any other items that the infected person has touched should be thoroughly disinfected and washed.

Carpets and floors should be steam cleaned whenever possible. Tile, hardwood, kitchen, and bathroom floors should be washed with hot soapy water and bleach. This regimen of household disinfecting should be performed on a daily basis until the scabies outbreak has been confirmed as cured by a healthcare professional, and on a routine basis for several weeks after to prevent re-infection.

Treatment of Family Members

Due to the highly contagious nature of scabies especially in close quarters, doctors frequently recommend treating the entire family for scabies even if only one member has contracted it. Given the propensity of the mite to spread and populate bedding, furniture, clothing, and other areas, it is highly likely that if one member of a family has scabies, other members either already have it or will have it shortly. Therefore, treating all family members for scabies at the same time is an effective method at preventing continual re-infection.

Care must be taken to ensure that once all family members are treated, scabies does not return and continue to re-infect members of the family. This requires a diligent household cleaning routine during and after treatment as the entire house must be disinfected in order to eradicate the outbreak.

Treatment Cost

Treatment for scabies is relatively inexpensive compared to other skin ailments. A 60ml tube of Elimite retails at around $35; sulfur soaps are much less, at an estimate $10 a bar. An 8oz bottle of Neem Oil has a comparable cost to sulfur soap.

Ivermectin (brand name Stromectol) is typically available in 3mg tablets. Costs for Stromectol are considerably higher (around $110 for treatment without insurance),

Prevention

There is no vaccine against scabies. Therefore, the best way to prevent scabies is to avoid prolonged contact, or any contact, with people infected with scabies. If scabies contact is suspected, any bedding, clothing, towels, or items the infected person may have touched should be immediately washed in very hot water and soap.

Adding a small amount of borax to laundry can also be helpful. Rugs and floors should be steam cleaned and vacuumed.

Permethrin sprays are often used to treat items or areas that cannot be laundered. A synthetic chemical and pesticide, care should be taken when using Permethrin around infants and pets. The EPA has also categorized Permethrin as a carcinogen in extremely strong concentrations. For household use, however, Permethrin sprays can kill scabies mites, dust miles, fleas, termites, and ticks.

Borax powder is natural remedy than can be sprinkled on carpets, floors, and other areas of the house to prevent and kill mites. While natural, boric acid can still irritate the skin in some individuals and animals, so caution should be used when applying.

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18 Comments

I started itching about 2 weeks ago, I thought originally that I have bed bugs but I never found any. I have bites all over including clusters of bites. No matter what I do, (constantly washing my clothes and taking 2 showers a day) I’m still itching.
Could it be scapies and if so, what do I need to do to get rid of them, how long will it take and how much will it cost?

I am a new grad NP and I came in contact with scabies 2 weeks ago…i was very careful to wear gloves ect. The family was 5 people in small room and the kids were running around touching everything. I tried to clean everything off immediately while wearing gloves. Now I have a few small red bumps popping up on my chest. none on wrist or hands yet (which I would think would happen first). I do not have any intense intching, just some normal itches here and there that go away if I touch/itch for a second. Do you think that I have scabies?

My wife had a very nasty, extremely itchy case of the scabies. She used Permethrin, which didn’t work, and even a tick shampoo for dogs, better but also didn’t work. Changed bedding everyday, vacuumed, bagged/washed clothes, but nothing worked. I slept in the same small bed with her, even making love, but I didn’t get the critters. She thought I was not infested due to using a natural body shampoo I made and used everyday. So I made up a bottle for her, she used it, and in 3 days she was cured! Unbelievable but true.

I will send a small bottle (3-5 applications) of my natural shampoo to anyone for free (no money, no postage fees, no shipping/handling, etc.). So what’s the catch? Just give me feedback if my natural ingredient shampoo is effective in both eliminating your scabies and also keeping you from being re-infected (I hate scabies!). Just send your address to my email clearrecord@juno.com, You don’t even have to include your name if you don’t want, and I will send it to your U.S. Postal address. Thanks for listening, Dave.

I’ve had scabies for over a year tryed everything along with wife,I wrk in mine and see everyone itching,its brought me to my end with a cry,as I nearly gave up,and came to the conclusion that this was my new life to co exsist these bloody things,I saw a post which this lady from UK used table salt in a bath,as I don’t have a bath at camp I filled a bottle with warm water and put 20 satchels of salt in there,sprayed my body face hair,and an hr latter I had bumps that opened and could feel them,7 hrs latter all sores look clean.Not to mention I went overboard and rub salt on me too,as you can imagine if you have them how I felt,I wanted them gone.wel,they are,thanks to the lady in the UK.

Okay, so, for some reason stray animals keep showing up in our yard. Idk if they are being left here or if they are coming from neighbors, bc we can’t see our neighbors due to quite a bit of wooded area between us. But anyhow, I’m an animal person, so I have to feed and care for an abandoned animal. It’s just how I am wired. Long story short, every animal has had scabies and I was infected with the things each time. I am certain it’s scabies bc I gave away two of those animals and the good ppl who adopted them took them to the vet and they were diagnosed with scabies. Well, the first time I was infected they seemed to have went away after maybe a week or so, without any special effort. Well, I have it a second time and looked online and someone suggested hot water, as hot as u can tolerate it without scalding. I was itching so bad so I took a shower (usually I take colder showers bc I have very sensitive skin and cold water soothes it and prevents it from flaring up) as hot as I could stand it and for an hour now there has been very little itching. Oh it’s so nice. But I feel like I should say that hot water apparently works and in time I think I will be rid of these pest again. I think hot water is what got them the first time bc back then I hadn’t realized my cold water trick for my skin and took very hot showers. So I think at least for my specific mite (evidently a cat mite since the stray this time is a cat) hot water works. The mite I got the first time was from a stray dog and hot water must have worked on it too. So try this along with ur normal stuff and maybe it will work for u like it did for me. good luck.

I recommend to contact a good farm vet ,, they deal with this very much
They have effective mite cide to spray and good advice ,,
Plan to do long term treatment ,, bag as much clothing and cloth material you can in bags seal them ,, buy plastic bed bag covers
Buy plastic bins with tops from Walmart for all of your clothing and bedding ,, buy 10 flea and tick dog collers put half a one in each bag and tub including your bed ,, spray it firs when putting it in the bag
Spray weekly cracks and corners , sprinkle borax in corners as well when dry ,, if you have carpets get a budget carpet cleaner service
Have them put a large bottle of wind ex and some borax in their water solution mayby some extra ammonia you must take pills and use lotin for your skin ,,, eucalyptus oil 30 drops in rubbing alcohol makes a great bed and body spray natural ,, is war get on it change all for them and for you !,,,,,,,, kill the bastards !!!!!!!! ,,,,,,, monthly bug bomb wouldn’t hurt !!!!!, have fun ,,,,,,

I had scabies and the best way to avoid of spreading it to other parts of the body is using baby wipes when it itches. Not only you are avoiding of spreading it but you are also avoiding of the eggs that come to the surface of the skin and then hatch.

I was prescribed the permethrin cream, ivermectin (Stromectol and neither worked. I was finally prescribed by a friend who is a nurse practioner Malathion lotion. This is the best thing to use. I also bought the Malathion insecticide and spray my house, my yard, my car and my office every day. I slept in the sofa so I could spray it everyday and put the sheets in the dryer as well as the towel after using it and all my clothing.

It was not easy to get rid of these creatures.

One becomes emotionally drained and my only comfort was praying that it would go away soon.

I have never had scabies before until now. How I got this is what is crazy and unusual. To get to the point, from my bathtub faucet while taking a BATH! I am still in this rental duplex as we speak, soon to get out. I believe there is a sewage line that got into the water line leading to my bathtub. I have these in my scalp, which are terrible. I have tried several doses of permetherin 5%, along with ivermectin 2 doses and to no avail. Rid shampoo, lice treatments, salt water, etc. I no longer take baths, but I am feeling very weak and sick. Please help. JJ519.

I have been infected for a second time. I had Scabies mites several yrs ago, and went through a whole lot of stress, tears, and misery trying to eradicate them! They prescribed the Permethrin Cream, and Ivermectin. I took three doses of Ivermectin and finally got rid of them after an 8 mo or so battle. I was literally going broke buying up all these products, and the cleaning supplies, trash bags, and bleach for mopping, etc…I live on a fixed income. Well this time I went to the Derm Dr. as fast as I could get an appt, and went to the walk in clinic until then and, asked for Ivermectin because that is what helped before. My dog had the mites first, and so I am pretty sure I have gotten these from her. I was so confused before and, this could have saved me from so much of a headache if I had been given the correct info from the get-go! I am disabled, and have a low immune system, and so she might have this as well. Right now , we are going through a series of dips for her, but I mean no more than 3 days, and these things are crawling all over her and, me , again! I am using mexican sulphur soap, witch hazel, gloves, twenty mule team borax when I have the money to buy it, and using windex to around the keyboard , and on counters, etc…they hate windex with ammonia in it, and lavender oil in my body lotion, and sometimes spraying with half listerine, and half water with a spray bottle to get them to leave me alone so I can sleep. I use benadryl for the itching. The oral kind, but the cream would help too. I am now taking Neem leaves in capsule form. 2 cap’s 3x a day. I am using bleach in my mop water, with stinky lavender fabulosa. I am going to the Derm Dr on Tues, and , I hope he decides that I am not a nut case, and allows me to get the medicine I need to get over this. I pray my lazy attendant will help me to vacuum and, dust, and with the laundry. I am so ill with fibro, and osteo arthritis, and parethesia in my feet and legs. I live on a limited income, and have no car to travel at my pleasure or for an important need. I have to wait for good weather, and I am trying to stay off of the bus, and not touch people. I am a loving and affectionate person, and so it is hard for me not to hug someone or shake their hand. I pray a lot! Also, Selsun blue Shampoo is supposed to help with the itching for dogs and humans.

I just got done taking a VERY HOT shower and while doing that I also put my clean clothes in the dryer for the extent of my showering time then after putting them on I thought I would try the acne pads that you get like Stridex and others and see if that works too and I will let you know the results later.